The Clinical Impact of Team Triage vs Conventional Triage on Patients With Acute Surgical Appendicitis or Cholecystitis.
Julia L Adams, Albert Tong, Patrick Chen, Jacob Leff, Adam Sigal, Traci S Deaner, Thomas Wasser
INTRODUCTION: Team triage incorporates collaborative evaluation by physicians and nurses during initial assessment, differing from conventional nurse-only triage models. Although previous studies have demonstrated improvements in wait times and patient satisfaction, diagnosis-specific clinical outcomes remain less well characterized. This study examined the impact of team triage on time-based performance metrics in patients diagnosed as having acute appendicitis or acute cholecystitis. METHODS: This retrospective, quasi-experimental study included 948 adult patients diagnosed as having appendicitis or cholecystitis between January 1, 2022, and May 31, 2024, at a large tertiary-care hospital. Patients were categorized into team triage or conventional triage groups. Variables included time to physician contact, diagnostic imaging order, antibiotic order, surgical consultation, analgesia order, disposition order, and hospital length of stay measures. Analyses were performed by diagnosis and by sex. RESULTS: Among patients with appendicitis, team triage significantly reduced time to physician contact, diagnostic imaging order, surgical consultation, and emergency department length of stay compared with conventional triage. Male patients demonstrated improvements across multiple metrics, including antibiotic order timing, whereas female patients showed significant improvements primarily in early diagnostic measures. In patients with cholecystitis, team triage significantly reduced the time to physician contact and diagnostic imaging order. Female patients also experienced earlier surgical consultation, whereas male patients demonstrated limited downstream benefit. Hospital length of stay did not differ significantly between triage models. DISCUSSION: Team triage enhances early diagnostic efficiency in time-sensitive surgical conditions, with effects varying by diagnosis and sex. These findings support collaborative triage models to enhance timely emergency care delivery.
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